The most important
decision a mother needs to make regarding feeding her infant is whether or not
to breastfeed, and if she decides to breastfeed, for how long and how
exclusively. This website will not attempt to add to what is already
widely available that presents the presumed benefits to babies of
breastfeeding. There is considerable information on the other side of
that question that has not been adequately presented to the general public,
which will be the main topic here.

According to the
American Academy of Family Physicians, "Throughout the middle part of
the 20th century,most
physicians did not advocate breastfeeding...."And beyond
that period, "in the late 20th century in the United States,
breastfeeding and formula feeding continued to be considered virtually
equivalent, representing merely a lifestyle choice...." (1)
It was only relatively recently that it became typical for doctors to promote
breastfeeding as a preferred alternative to formula for feeding babies.
After such a major change in opinions on an important matter (knowing that
people are very much subject to bandwagon effects), it is worth slowing down
and trying to determine just how good the evidence is to support reversing a
position that had prevailed for several decades. There are substantial
reasons not to follow along with this latest turn. That is especially
true since U.S. Surgeon General Regina Benjamin points out that all of the
studies that have found benefits of breastfeeding are of the
"observational" type, which she says provide information that can
lead only to inferences;(2) according to the American
Heritage dictionary (Fourth Edition, 2009), a synonym of ”infer" is
"surmise," and "surmising" is defined as something done
"without sufficiently conclusive evidence."

So, by the highest
U.S. authority, the case in favor of breastfeeding is built merely on studies
of the kind that are inconclusive and that can only find associations,such as the association
between high death rates in Florida and sunshine. From such studies, one
can arrive at inferences, such as

(a) that sunshine
causes deaths, while overlooking the factor of the old average age of Florida
residents, or

(b) that
breastfeeding prevents certain illnesses in babies, while overlooking the
underlying factors of low income and smoking that are known to be
disproportionately prevalent in bottle-feeding households, and which are known
to result in those same illnesses in babies and infants.

The U.S. Agency for
Healthcare Research and Quality (AHRQ) points out that observational studies
are subject to false conclusion,(3) because of
the difficult-to-determine effects of confounding factors. But lactation
promoters nevertheless refer to such studies as conclusive evidence of benefits
to babies of breastfeeding.They especially point to a review of
such studies that was contracted by the AHRQ, which told about some associations
of breastfeeding with certain reduced illnesses in infants (from among
many hundreds of different possible diseases and conditions); this
review also emphasized that there was no evidence showing that breastfeeding
was a cause of any reduced illnesses. Proponents of breastfeeding
look at the very limited statements about possible benefits of breastfeeding
and try to use them to justify believing that bottle-feeding of babies has proven
drawbacks; they also improperly try to attribute credibility to this
report by referring to it as "the AHRQ review," even though the AHRQ clearly
distanced itself from this contracted report by stating conspicuously at its
front,“No
statement in this report should be construed as an official position of AHRQ.”(4)

Regarding the studies
that were considered in the report, all the AHRQ-contracted reviewers asked
was, “Did authors consider appropriate confounders and justification for
adjusting or not adjusting for those confounders?” “Yes” was the highest
possible rating; there was no attempt to assess whether the difficult,
complex process of properly dealing with such confounders was done competently.
In addition, the authors routinely gave A ratings to studies that apparently didn't
even consider known confounders.(5) And even after they
had assigned grades to the studies, these reviewers sometimes essentially
ignored the significance of their grades: Most of the A-graded
studies of the association between breastfeeding and SIDS found no
beneficial effects of breastfeeding with regard to SIDS; but the
reviewers nevertheless "pooled" results of studies that included ones
they recognized to be of poor quality, and used the pooled figures to conclude
with a finding of an association between breastfeeding and reduced incidence of
SIDS. Their conclusion stated only the result of this dubious pooling
process, and nothing was mentioned in the conclusion about the findings (not
favorable to breastfeeding) reached by the majority of the A-graded studies.

So the U.S. Surgeon
General points out that the studies finding benefits of breastfeeding to babies
are essentially all merely observational studies, the kind that the AHRQ says
are subject to false conclusion. The relevant Policy Statement of the
American Academy of Pediatrics (AAP), "Breastfeeding and the Use of Human
Milk," makes several unjustifiable statements indicating certainty, such
as, "Any breastfeeding compared with exclusive commercial infant formula
feeding will reduce the incidence of otitis media (OM) by 23%."(6)
When several high AAP officials were challenged on these unjustifiable claims
of certainty in letters from the author of this website, as of seven months
later those officials had failed to respond. The AAP attempts to support
its position by improperly referring to the "AHRQ metaanalyses,"
meaning the very same contracted review that the AHRQ had conspicuously
said in the opening page should not "be construed as an official
position of AHRQ.” That isn't even to mention the obvious deficiencies of
that review (touched on in the previous paragraph) and the extremely restricted
nature of the favorable findings regarding breastfeeding.

Aside from the
weaknesses of the evidence that is used in the attempt to indicate benefits of
breastfeeding, there is considerable relevant historical evidence
covering the period of transition from low-breastfeeding to high
breastfeeding. This evidence shows that health outcomes among the
highly-breastfed generations of infants have become substantially worse
with respect to all but one of the conditions alleged to be reduced by
breastfeeding. In three or more of those areas, new "epidemics"
have been declared among children and young people whose infancies took place
during the period of higher breastfeeding. Much more on this topic will
come later.

Moreover, there are manystudies
that have found breastfeeding to be associated with adverse health
outcomes, including 26 studies just in the categories of asthma, allergies, and
diabetes alone, as well as three regarding autism (including
a study of all 50 U.S. states and 51 U.S. counties finding amounts of
breastfeeding to be directly correlated with autism prevalence), and one major
study showing a direct, dose-response relationship between specific toxins in
breast milk received from mothers and ADHD-like behavior in the
children. For itemization of the above, see www.breastfeeding-studies.info.

...................................................................

Q: If
the case in favor of breastfeeding is not based on good evidence, what
difference should that make, since it's such a natural way of feeding a baby,
and since it's been done since the beginning?

A: Well,
it's natural in the same way that drinking water out of a local stream is
natural. It was the best thing available (or the only usable infant food)
in the early days of the human species; and it worked well enough that
the human race multiplied, as long as almost every woman bore many
children. But there are many toxic chemicals prevalent in today's
environments of industrialized countries, most of which tend to become
concentrated in breast milk. The pro-breastfeeding organization, MOMS
(Making Our Milk Safe), in addition to other toxic chemicals contained in
breast milk, also listsBisphenol
A (endocrine disruptors), perchlorate (used in rocket fuel),
perfluorinated chemicals (PFCs, used in floor cleaners and non-stick pans), polyvinyl
chloride (PVC, commonly known as vinyl) and the heavy metals cadmium, lead and mercury.(7)“One property of breast milk is that its high-fat and -protein content
attracts heavy metals and other contaminants,”according to a New York Times
article and also as stated by the NIH.(8)
Well-researched suggestions as to ten specific environmental chemicals that are
said to justify further research as possible causes of autism have recently been
presented by very authoritative authors: Philip Landrigan, MD,
MSc, Director of the Children's Environmental Health Center at Mount Sinai
School of Medicine, and others, including the Director of the National
Institute of Environmental Health Sciences. Those chemicals include lead,
mercury, PCBs, certain classes of pesticides, endocrine disruptors
(which include dioxins), PAHs, perfluorinated compounds, and PBDEs
(brominated flame retardants). (9)Most or all of those chemicals have been found to be present in breast
milk, some of them in high concentrations. Just two of those
chemicals will be mentioned briefly here, with a link for much more information
about these and the other toxins to follow:

a) An EPA study estimated the average daily exposure of a breastfed
infant to dioxin toxicity to be 86 times higher than the
reasonably-safe upper threshold of dioxin exposure estimated by the EPA in
2012. (60 pg of TEQ/kg bw/day vs. 0.7 pg
of TEQ/kg bw/day) (9a)

The accumulated
dioxin toxic equivalency exposure in infants that had been breastfed for one
year was estimated to be about 6 times higher than in infants that had not been
breastfed, in an EPA study. (10)

Note that dioxin has
been determined by the EPA to be both a known carcinogen and a
neuro-developmental toxin/ endocrine disruptor.

b) Typical breast milk appears
to be over 50 times as high as infant formula in PBDEs. (10a) A major study found that children who had consumed
breast milk with top-quartile levels of PBDEs were 3.3 times as likely
(compared with those below median) to have high scores inactivity/impulsivity
behavior, of a kind that indicated likelihood of developing into Attention
Deficit/Hyperactivity Disorder. Those whose breast milk levels were merely
above average in PBDEs had over twice the assessed likelihood of developing
into ADHD, compared with children whose equivalent levels were below average. (For
more about effects of PBDEs on children, see Section 2.a of www.breastfeeding-toxins.info.)

Breastfeeding rates
in the U.S. increased greatly after 1972, so we now have several decades of
historical health data that enable us to make an educated "before and after"
comparison to see whether the inferences about breastfeeding's presumed
benefits turned out to have been correct. Assuming some validity to the
claims about benefits to an infant resulting from breastfeeding, it would be
reasonable to expect improvements in the health data of the generations of
children who came to be highly breastfed.

As it turns out, not a single one of the favorable
health outcomes that would have been predicted on the basis of the claims for
benefits of breastfeeding has materialized, as shown by actual historical
health data for those generations. And in fact, the actual outcomes have turned out
to be substantially worsein all but one of the conditions and diseases
that would have been expected to improve based on those claims. A
point-by-point examination has been carried out regarding each of the principal
claims made for benefits of breastfeeding in relation to the actual health
outcomes of the generations who started to be highly breastfed beginning in the
1970's; the health outcomes of the highly-breastfed generations are also
compared with the health outcomes of the low-breastfed generation that preceded
them; to see these comparisons, go to www.breastfeedingprosandcons.info
.

There is also
considerable government health data regarding the rise and major growth of ADHD and serious psychological problems
following the transition to high breastfeeding, which can be read about in Section
2 of http://www.breastfeeding-health-effects.info.

There is considerable
information about the dramatic increases in childhood diabetes that
apparently took place following the great increases in breastfeeding, which can
be read at www.breastfeeding-and-diabetes.info.
To read about increases in childhood obesity that have taken place in
extremely close correlation with increases in breastfeeding, see www.breastfeeding-and-obesity.info.
There is also a great deal of information about increases in asthma and allergies
that took place following the increases in breastfeeding, which can be read
about at www.breastfeeding-and-asthma.info.

. . . . . . . . . . . . . . . . . . . . . . . . .

It will seem surprising
how far off the inferences about "risks" of not breastfeeding turned
out to have been in relation to what actually happened. There are various
reasons for this:

(a) The selectivity that has been exercised by breastfeeding's
promoters, in finding and quoting certain studies that support their position
while ignoring the many studies that disagree with their position. In the
areas of asthmas and allergies, for instance, allegations are made based on some
studies that these diseases are increased by breastfeeding; but nothing
is mentioned about the 20 studies just in the areas of asthma
and allergies alone that found that those diseases actually increased
among children who were more breastfed. (see the last link above)

(b) "Confounders" can cause the inferences from observational studies
to be in error; and there were major confounders present in those
studies that were done about breastfeeding, which were either not recognized or
properly adjusted or controlled for: low income conditions and
household smoking, both of which are known to be disproportionately present in
bottle-feeding households. Section D of www.breastfeeding-benefits.netgoes into detail about those confounders and about how each of them is
known to cause the same adverse health outcomes that have been
attributed to lack of breastfeeding.

(c) The fact that lactation effectively takes in known developmental
toxins (of kinds that have come to be increasingly present in environments
of developed countries) and concentrates them in breast milk;
most of the toxins are attracted to fat and hence to the fat content of the
milk; (for more about this, go to www.breastfeeding-toxins.info)
and

(d) the increasingly well-accepted theory that proper development of an
infant's immune system depends on the immune system's being challenged by
everyday microbes, such as those that are attacked by immune cells in breast
milk. That "hygiene hypothesis" is generally discussed
in reference to improved conditions in contemporary developed countries as
compared with those of earlier times. But modern sanitation and hygiene
had already been achieved early in the 20th Century; and it
was apparently not until the 1970's that a great many children's immune
systems started failing to develop well; this came directly following
the great increase in breastfeeding, with its injection of immune cells from
outside an infant's body. It was only following the 1970's that
"epidemics" were declared in obesity, childhood diabetes, and asthma
and allergies in general, and later in autism. For more about the hygiene
hypothesis, see Section 1 of www.breastfeeding-and-asthma.info.

Additional details
and sources for the above will follow in this paper.

A question that should be addressed to those who are
recommending breastfeeding, but which they probably won't want to answer:

Given (a) the
inconclusiveness of the studies that support breastfeeding and the selectivity
exercised when choosing to cite only the studies favorable to breastfeeding,** (b)
the known concentrations of environmental toxins in recent human milk,** and
(c) the many close correlations between variations in breastfeeding levels and
similar variations in levels of several epidemics of childhood diseases (seen in national health data**):How do we know that
breastfeeding is more beneficial than harmful?

______________

** Supporting
information and references to authoritative sources regarding matters raised in
this question are included in a one-page printable version of this question,
to be found at www.pollutionaction.org/Q.pdf
.

We have good reason
to say that those who recommend breastfeeding probably will not have an answer
to the above question. Slightly different versions of essentially this
same question were mailed twice to four different high officials at the U.S.
Department of Health and Human Services, who are heads of divisions that are
involved in promoting breastfeeding. As of 3 months and more after mailing
those letters, no reply has been received. Several months earlier, each
of those officials had sent one response to an earlier letter that brought up
the matters above, and none of their responses said anything in criticism of
any of those points. Those points are all well substantiated. Three
or more letters each to the American Academy of Pediatrics, the American
Academy of Family Physicians and the American Congress of Obstetricians and
Gynecologists have all brought similarly poor responses: no replies
have been received to any of those letters, as of over a year later. The
question that comes at the end, above, is a logical question to ask, especially
when addressed to people who actively promote feeding infants a substance known
(with no disagreement) to contain very high levels of developmental
toxins. But the promoters of breastfeeding appear to be unwilling or
unable to respond to this question. If they can't or won't answer
that question as part of an informed debate on this matter (therefore
to dm@pollutionaction.org, as well as to you), should anybody pay
attention to their advice?

In contrast with the blind
eye turned by the doctors’ associations, we have received responses to our
various publications from seven individual doctors as well as from members of
the general public. Some of the doctors have responded negatively, but
three have been very favorable and two highly recommended our publications to
readers of their doctor’s blogs. Their comments, and those of other
readers, put into more readable, conversational form some of the points raised
in more detailed form in some of our publications. We invite you to read
those comments at www.pollutionaction.org/comments.htm.

It is very well
established that the way to develop long-lasting immunity is to subject the
body to weak microbial challenges, so that the person's own immune system
develops capabilities. By contrast, immune cells from an external
source (such as human milk) provide short-term immunity; they shield an
infant from infections that, in developed countries, (a) would generally be
non-serious, and (b) would actually be stimulative to the development of the
infant's immune system. It should not be surprising that the benefits of
reducing infections in the near term turn out to be outweighed by the long-term
effects of having done so.

The
table above is a small part of the evidence presented at www.breastfeedingprosandcons.info
pointing out that, in almost every case of "excess risks" that are
alleged to apply to not breastfeeding, the actual health outcomes for the
generations who were born following the increases in breastfeeding were
actually much worse than was the case for the low-breastfed generation that
preceded them.

ADHD and
psychological problems among children and young people first becoming
widespread following increases in breastfeeding - - the testosterone connection

The American
Psychiatric Association first coined the term "Attention Deficit
Hyperactivity Disorder" (ADHD) in 1980, (41) eight years
into the period of rapidly-rising breastfeeding rates. And, as shown in
this CDC chart, "serious
emotional or behavioral difficulties" in children were
apparently not considered significant enough by the CDC to justify reporting
about them until well into the period of increasing breastfeeding.
Before reaching the 5% level in the first data provided, those emotional or
behavioral difficulties rates must have been building for many years before the
2003 year of the first data shown. Extrapolating backward from the
roughly 14% per 5 years growth rate shown in the above table would arrive at an
extremely low level as of the 1970's; this would be fully compatible
with origin of this condition's rapid growth in an infant exposure that greatly
increased beginning in the early 1970's.

As explained in www.breastfeeding-toxins.info,
citing several authoritative sources, chemicals that are concentrated in
breast milk (and which are many times lower in bottle feedings) are known, on
the basis of high-quality scientific studies, to have de-masculinizing,
anti-androgenic, testosterone-reducing effects.
According to Web MD, the leading effects of low testosterone are not only low sex drive but
also "diminishing ability to concentrate,
as well as irritability and depression."
Also, quoting a urology department chairman,"diminished mental
clarity, motivation, drive -- all of these things can be related to low
testosterone." (42) Scientific literature points out that
testosterone has important effects not only on ability to concentrate but also
on mood, memory, and "the overall sense of vigor and well being."
(43)

The above is only an
introduction to the subject of probable effects of breastfeeding on increases in
ADHD and serious psychological problems among the young. For the complete
section on this subject, go to Section 2 of http://www.breastfeeding-health-effects.info

*******************************************************************

Message
to health professionals and scientistsreading this paper: This
author cordially invites you to indicate your reactions to the contents
presented here. As of now, new parents almost never hear anything but
completely one-sided promotion of breastfeeding, with no mention of possible
drawbacks except in cases of serious problems on the part of the mother.
If you feel that parents should be informed about both sides of this question
and thereby enabled to make an educated decision in this important matter,
please write to the author of this paper. Also, if you find anything here
that you feel isn't accurately drawn from trustworthy sources or based on sound
reasoning, please by all means send your comments, to dm@pollutionaction.org.

***Comments
from readers:

From this paper's
inception in early 2012 until present, the invitation has been extended to all
readers to submit criticisms of contents of this paper, asking them to point
out how anything written here is not well supported by authoritative sources
(as cited) or is not logically based on the evidence presented. As of May
4, 2013, after more than a year, no criticisms of contents of this paper have
yet been received in response to that invitation. (That is significant,
considering the thousands of visits we receive from readers every month.)
We have received some e-mails that have not criticized contents of this paper
but which are of interest; several of those comments or inquiries and
our responses to them are entered at www.pollutionaction.org/comments.htm
. All comments are welcome, especially those that point out any deficiencies
in our evidence in relation to conclusions drawn or any lack of quality in the
reasoning as presented. Please send comments or questions to dm@pollutionaction.org
.

(4) Breastfeeding and
Maternal and Infant Health Outcomes in Developed Countries Prepared for:
Agency for Healthcare Research and Quality, US HHS (Evidence Report/Technology
Assessment Number 153, Part 1. Acknowledgement of lack of demonstrated
causality in "Structured Abstract" in front.

(9a)http://www.epa.gov/iris/supdocs/dioxinv1sup.pdf
in section 4.3.5, at end of that section, "...the resulting
RfD in standard units is 7 × 10−10 mg/kg-day." In the
EPA’s “Glossary of Health Effects”, RfD is defined: “RfD (oral reference
dose): An estimate (with uncertainty spanning perhaps an order of magnitude) of
a daily oral exposure of a chemical to the human population (including
sensitive subpopulations) that is likely to be without risk of deleterious
noncancer effects during a lifetime.